Quality of Life After Sentinel Lymph Node Biopsy or Axillary Lymph Node Dissection in Stage I/II Breast Cancer Patients: A Prospective Longitudinal Study

Abstract

Background: Breast cancer patients' quality of life (QoL) after surgery has been reported to improve significantly over time. Little is known about QoL recovery after sentinel lymph node biopsy (SLNB) in comparison to axillary lymph node dissection (ALND).Methods: 175 of 195 stage I/II breast cancer patients completed the EORTC QLQ-C30: one day before surgery (T0) and after 6 (T1), 26 (T2), 52 (T3) and 104 (T4) weeks. Of these, 54 patients underwent SLNB, 56 SLNB+ALND and 65 ALND. General linear models and paired T-tests between T0-T4 and T1-T4 were computed. Complications, radiotherapy and systemic therapy were added to the model.Results: Significant time effects were found on physical, role and emotional functioning. Physical and role functioning decreased between T0 and T1. At T4, SLNB patients' functioning had increased to their T0 level; ALND (+/-SLNB) patients' functioning had increased, but had not improved to T0 level. Emotional functioning increased linearly between T0 and T4. At T4, emotional functioning was significantly higher in all groups as compared with T0. No significant group or interaction (time 9 group) effects were found. Complications and chemotherapy had a significant negative effect on role, emotional and cognitive functioning. Complications had a significant effect on social functioning also. Effect sizes varied between 0.00 and 0.06.Conclusion: Two years post surgery, breast cancer patients' QoL is comparable to that shortly before surgery. Women rated their emotional functioning as even better. SLNB is not associated with a better QoL than ALND. However, undergoing systemic therapy and/or experiencing complications affects QoL negatively.

Functional performance of upper limb and quality of life after sentinel lymph node biopsy of breast cancer

“…Breast cancer is the second most prevalent type of cancer worldwide and the most common in women 1 . Surgical procedures and adjuvant therapy may lead to ipsilateral functional limitation in the shoulder girdle.…”

O impacto da biópsia do linfonodo sentinela na qualidade de vida de mulheres submetidas à cirurgia conservadora de mama

“…Quanto ao medo de recorrência, achados da literatura apontam resultados conflitantes entre as técnicas de mastectomia radical e conservadora 11,13 . Enquanto alguns estudos sugerem ausência de diferença, outros apontam maior medo de recorrência, e piores escores, entre as pacientes submetidas à mastectomia 9,16 .…”

“…Posteriormente, outros estudos apontaram que a técnica da SBLS apresentava impacto ainda melhor na QV, quando comparada à SLAT 10,11 . No entanto, outros autores apontaram que a QV não apresenta diferenças significativas entre pacientes submetidas à SBLS ou à SLAT após dois anos do procedimento 13 . O instrumento de avaliação da QV em pacientes submetidas à cirurgia mamária da Organização Europeia para a Pesquisa e Tratamento do Câncer (EORTC) não se limita exclusivamente a aspectos subjetivos do estado de saúde das pacientes, já que analisa também aspectos relacionados à terapia, como imagem corporal, funcionamento sexual, perspectivas quanto ao futuro, efeitos colaterais da terapia, sintomas mamários e do braço 14 .…”

Effectiveness of Physiotherapy Intervention on the Quality of Life of Women with Breast Cancer who Underwent Sentinel Lymph Node Biopsy.

“…In this study, the GHS scale was chosen to calculate the sample size, since it is the one most often used in the reference literature [9][10][11][12]. As the study had four evaluation moments, we opted to choose the moment when the group of patients, according to our literature survey, would have a lower score in the parameter in question (GHS), that is, at 6 months after surgery.…”

“…However, in the acute survival phase [7,8], when oncological therapies are performed during the first year following diagnosis, the effect of therapies such as chemotherapy, radiotherapy, hormone therapy, and immunotherapy can overcome the lower aggressiveness of the surgery, leading to no differences in quality of life (QoL) between the two groups of patients [9][10][11][12].…”